Provider Demographics
NPI:1992493753
Name:GUTIERREZ, KARIN LORENE (LPC)
Entity type:Individual
Prefix:
First Name:KARIN
Middle Name:LORENE
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KARIN
Other - Middle Name:LORENE
Other - Last Name:OCAMPO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3915 N ALBANY AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-3401
Mailing Address - Country:US
Mailing Address - Phone:773-366-6353
Mailing Address - Fax:
Practice Address - Street 1:3915 N ALBANY AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-3401
Practice Address - Country:US
Practice Address - Phone:773-366-6353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178019029101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional